Published by Charlotte Pickles on 19 April 2017
- Our Work
- The Reformer Blog
21 April 2017
Ideas are back at the heart of politics. Brexit, Trump and elections across the Channel show this. The upcoming General Election will be more than about Brexit negotiations, despite them being offered as the reason behind the Prime Minister’s unexpected poll.
Theresa May is looking to “define her own domestic agenda”. Jeremy Corbyn started the campaign by focusing on the NHS, schools and the economy. Domestic policy should excite more than Westminster; it will directly affect the lives of everyone.
The next Government must change the way it operates to meet people’s expectations. Life is increasingly conducted digitally, and the overwhelming message from Brexit is the need to create a government that works for citizens, not the other way around.
Digital government means more responsive, accessible services for citizens. A two-week wait for a GP should not be acceptable in a world where a video call can be offered within hours. Police forces can interact with citizens through social media. Councils should operate online, through chatbots, rather than tired town halls. This can be done while saving money for taxpayers: automating 250,000 administrative roles in Whitehall and the NHS, saving over £4 billion against this year’s wage bill.
This would go some way to creating a government that serves citizens. This is crucial in a post-Brexit world. Over 17 million people backed a campaign promising to “take back control”; Whitehall feels irresponsive to the needs of local communities.
Polling shows that all regions support local decision making of public services. There is a compelling case for devolution to tailor services to local needs and reduce the current postcode lottery in service outcomes. The next Government should be open to radical localism. Mayors, elected in two weeks, can lead the argument. Reform research on how this looks for designing public services is forthcoming.
2. Improve life chances
Improving the life chances of all has quite rightly been at the top of the political agenda in recent years. On the steps of Downing Street last year, Theresa May firmly set out her aim to fight against “burning injustices” in the education system and the economy.
Parents and carers are desperate to send their children to the best schools. The country needs 7 per cent more school places by 2020-21. These schools should not be selective, which are shown to disproportionately benefit wealthier families (with five times fewer pupils on free school meals). Widening or removing catchment area boundaries, alongside random allocation of oversubscribed schools, could improve access to the best schools for the poorest pupils.
Employment may be at the highest rate since records began, but more can be done to make the country work for all. People who have been out of work for long periods and those with health conditions, including mental ill-health, are most likely to be without work.
With the short-term economic impact of Brexit unclear, the next Government should focus on how to help vulnerable people into work. This should involve outsourced, payment-by-results contracts commissioned, where possible, locally. Government-run jobcentres should be digitised to better use data to create personalised back-to-work programmes and share their knowledge of local labour markets to inform local employers’ decisions. Meaningful employment is, after all, a critical means of increasing people’s wellbeing and will help avoid a host of healthcare issues.
3. Improve healthcare
Behind Brexit, voters rank the NHS as the most important issue facing their families. Getting healthcare reform right has eluded both major parties in government. More money failed to lead to better outcomes: systematic change is needed to create a sustainable NHS. At the beginning of this year, the Office for Budget Responsibility said the NHS is driving public finances to “unsustainable” levels.
The next Government should resist calls for ever more funding, and focus on shifting care away from hospitals. People don’t want, or, in many cases need, to be there.
Self-care, enabled by technology, can be used more effectively for the 15 million people with long-term conditions. Care must be shifted from hospitals into the community, including urgent care and diagnostics. The next Prime Minister should drop the current target to employ 5,000 more GPs – instead focusing on using technology, nurses, pharmacists and physiotherapists to meet demand. Commissioning health services from pooled, local budgets can incentivise this shift.
Social care is in crisis. The OBR expects expenditure on it to increase by 50 per cent, as people live longer, but not healthier, lives. Government can make it easier for those who self-fund care by widening the deferred-payment agreement (which allows people to use the value of their homes to pay for social care) to those with non-housing assets of up to £100,000 (from the current £23,250). Longer-term reform should follow, as Reform will set out.
4. Create a fair society
These changes should be made against a backdrop of a fair society. The Prime Minister’s remarks that “the country is coming together” will not be felt by all. The split between older people (who vote more) and the younger generations is long standing.
Public policy can respond. The triple lock on the State Pension (which increases it by the higher of inflation, earnings or 2.5 per cent each year) now benefits the least likely group in society to be in income poverty – at a cumulative cost of £20 billion next year. At the same time, many working-age benefits have been frozen until 2019-20, which – with inflation creeping up – is going to be felt acutely over the coming years. The Government should take the opportunity to replace the triple lock with an earnings-linked index and design an inflation-linked Benefits Uprating Index for claimants. This would help ensure fairness and sustainability of public finances.
These are extraordinary political times, and the complexities of Brexit are huge. But they should not distract from domestic policy. Manifestos are five-year contracts with citizens. The negotiations will end in two years; people’s lives will go on.
Alexander Hitchcock, Senior Researcher, Reform